Public Health as Politics: Legitimacy and the Mecca Gureba Hospital in the Late Ottoman Hejaz

Originally founded through the waqf system to provide medical care for the poor, gureba hospitals gradually evolved into key institutions within the Ottoman modernization and social welfare policies. Focusing on the Mecca Gureba Hospital, this study argues that health institutions served as strategic instruments to sustain the Ottoman Empire’s social, administrative, and symbolic presence in the Hejaz. Located in Mecca—a city of profound religious and political significance—the hospital addressed the medical needs of both the local population and Muslim pilgrims. Drawing on Ottoman archival documents, this study examines the hospital’s financial resources, personnel structure, and daily operations, including its role during cholera outbreaks. It also analyzes the administrative organization, central oversight mechanisms, and procedures for appointing physicians and staff, illustrating processes of institutionalization within the Ottoman provincial health system. The study shows that gureba hospitals functioned both as charitable institutions rooted in waqf traditions and as instruments of modernization, enabling the central authority to project its legitimacy in the provinces amid Pan-Islamic policies.